Jefferson cardiologists fix broken heart

Jan 08, 2007

Unexplained chest pain after a heart attack might be more dangerous than many physicians originally think.

In a case study to be published in the January issue of the international journal
Clinical Cardiology, physicians at Thomas Jefferson University Hospital in Philadelphia report on a seemingly healthy 55-year-old man who had a silent heart attack and subsequent unexplained chest pain.

Once he was admitted to the hospital, it was discovered that the man actually had a rarely diagnosed complication called subepicardial aneurysm, which, if not quickly treated, could be fatal.

"The chest pain was a rupture of the heart wall about to happen--the most feared complication of a heart attack," explains Michael Savage, M.D., director, Cardiac Catheterization Laboratory at Thomas Jefferson University Hospital. "The rupture occurs from a tear in the muscle that has already been damaged by a heart attack. The heart muscle breaks and the wall bursts usually causing cataclysmic death soon after."

The Jefferson researchers recommend that when a patient experiences unexplained pain after a heart attack, physicians should consider the possibility of a subepicardial aneurysm.

Diagnosis of a subepicardial aneurysm is extremely rare, says Dr. Savage, who is also associate professor of Medicine, Jefferson Medical College of Thomas Jefferson University. Only 20 cases have ever been reported in the medical literature and many patients were diagnosed after death. It is highly likely that many more patients have died from this complication but the cause of death was unrecognized.

According to lead researcher, Aaron Giltner, M.D., a cardiology fellow at Thomas Jefferson University Hospital, the man, who worked in construction, came to the Thomas Jefferson University Hospital emergency room with chest pain. A heart attack was initially considered and the emergency physicians called in the interventional cardiologists for a consult.

The cardiologists also initially suspected a heart attack. The patient was admitted to the hospital and was readied for a cardiac catheterization to check for blocked arteries.

The cardiac catheterization suggested a subepicardial aneurysm--an impending cardiac rupture--and the researchers arranged for a CT scan. This confirmed that the patient had a subepicardial aneurysm, a rarely diagnosed complication of a heart attack. Once the problem was identified, surgeons promptly repaired the heart, saving his life.

"As our study shows," Dr. Savage says, "CT imaging can be invaluable in establishing the diagnosis of a subepicardial aneurysm. Clinical recognition of this entity and the use of appropriate imaging modalities are imperative to facilitate life-saving surgical intervention."

Source: Thomas Jefferson University

Explore further: Gut microbial mix relates to stages of blood sugar control

add to favorites email to friend print save as pdf

Related Stories

Why your laptop battery won't kill you

8 hours ago

News on Tuesday that major U.S. airlines are no longer going to ship powerful lithium-ion batteries might lead some to fret about the safety of their personal electronic devices.

Visa, MasterCard moving into mobile pay in Africa

8 hours ago

Americans may just be getting used to mobile pay, but consumers in many African countries have been paying with their phones for years. Now payment processors Visa and MasterCard want to get a slice of that market, and are ...

Recommended for you

Radical vaccine design effective against herpes viruses

1 hour ago

Herpes simplex virus infections are an enormous global health problem and there is currently no viable vaccine. For nearly three decades, immunologists' efforts to develop a herpes vaccine have centered on ...

Popular antioxidant likely ineffective, study finds

10 hours ago

The popular dietary supplement ubiquinone, also known as Coenzyme Q10, is widely believed to function as an antioxidant, protecting cells against damage from free radicals. But a new study by scientists at McGill University ...

New findings on 'key players' in brain inflammation

10 hours ago

Inflammation is the immune system's natural reaction to an 'aggressor' in the body or an injury, but if the inflammatory response is too strong it becomes harmful. For example, inflammation in the brain occurs ...

Gut microbial mix relates to stages of blood sugar control

Mar 05, 2015

The composition of intestinal bacteria and other micro-organisms—called the gut microbiota—changes over time in unhealthy ways in black men who are prediabetic, a new study finds. The results will be presented Friday ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.